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This is VAERS ID 902948

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902948
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol
Diagnostic Lab Data: none
CDC 'Split Type': IHS

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


Changed on 12/24/2020

VAERS ID: 902948 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol Tramadol
Diagnostic Lab Data: none
CDC 'Split Type': IHS

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


Changed on 12/30/2020

VAERS ID: 902948 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol Tramadol
Diagnostic Lab Data: none
CDC 'Split Type': IHS

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


Changed on 2/4/2021

VAERS ID: 902948 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol
Diagnostic Lab Data: none
CDC 'Split Type': IHS (blank)

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


Changed on 5/7/2021

VAERS ID: 902948 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol Tramadol
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.


Changed on 5/21/2021

VAERS ID: 902948 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:Oklahoma
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash pustular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg bid Irbesartan 150mg qd Depo-testosterone 200mg IM 2qwks
Current Illness: None
Preexisting Conditions: Diabetes mellitus, type 2 Hypertension
Allergies: Tramadol Tramadol
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Papular, pustular rash on back occurring approximately 6-10 hours after injection of vaccine.

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